Psychedelics: Difference between revisions

'''Psychedelics are [[Drugs|medicinal compounds]] that induce [[Pivotal Mental States]]. Given the correct [[priming]] (set), [[setting]] and [[integration]] they can have potent [[psychoplastogen]] effects on mental health.''' In some countries, psychedelics are classified as illegal, however, with the advent of [[The Psychedelic Renaissance|the psychedelic renaissance]] this taboo is lifting, leading to decriminalisation, [[Psychedelic Prevalence|increased domestic use]] and [[Medical Tourism|medical tourism]].

 

During the [[Psychedelic Experience|psychedelic experience,]] as shown in the illustrated brain scan to the right ('''Figure 1''') parts of the brain which do not usually communicate with one another start talking, and subconscious inputs open up to the conscious mind. The experience is thought to open a [[Neuroplasticity|neuroplastic]] window giving users an opportunity to correct ruminating thought patterns thought to be the basis of [[Mental Illness|mental illnesses]] such as bipolarity<ref>'''Risks and benefits of psilocybin use in people with bipolar disorder: An international web-based survey on experiences of ‘magic mushroom’ consumption'''. Emma Morton, Kimberly Sakai, and Josh Woolley. Volume 37, Issue . <nowiki>https://doi.org/10.1177/02698811221131997</nowiki>. Accessed 23 Jan 2023 via https://journals.sagepub.com/doi/full/10.1177/02698811221131997</ref>, [[depression]], anxiety.

<div class="res-img">[[File:History of Psychedelics1.png|alt=Psychedelics History|center|CHistory of Psychedelics]]</div>

Psychedelics have been used by human civilisations for over 3,000 years. Only recently, since the 1970s, have they been mired in [[War on Drugs|taboo]]. Currently, there is a resurgence of interest in the medicines termed the [[The Psychedelic Renaissance]] which is showing that in fact, they are one of the safest, most effective compounds for the treatment of various mental health conditions.

There are 5 classes of psychedelics based on their effect and chemistry.  

* Depersonalization

* Personal bias suppression

Like all medicines, psychedelics are not without potential harm. However, relative to all other drugs (See '''Figure 3''') risk associated with their use is minimal. In a clinical sense, under specific [[priming]], [[setting]] and [[integration]] there is abundant evidence for the safety and efficacy for their use in the treatment of:  

* '''Cyclical thought patterns:'''

**'''Depression''' - multiple meta-analyses results suggest that psychedelic-assisted therapy is effective with minimal adverse effects<ref>'''Classic serotonergic psychedelics for mood and depressive symptoms: a meta-analysis of mood disorder patients and healthy participants'''. Nicole L. Galvão-Coelho, Psychopharmacology (Berl). 2021; 238(2): 341–354. Published online 2021 Jan 11. doi: 10.1007/s00213-020-05719-1. Accessed on 16th September 2022 via https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7826317/pdf/213_2020_Article_5719.pdf</ref><ref>'''''A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy'''. Luoma, J. B., Chwyl, C., Bathje, G. J., Davis, A. K., & Lancelotta, R. (2020).  Journal of Psychoactive Drugs, 1–11.'' doi:10.1080/02791072.2020.1769878. Accessed on 16th September 2022 via: https://pubmed.ncbi.nlm.nih.gov/32529966/ </ref>, relative to a comparable meta analysis of the effects of 21 traditional antidepressant drugs<ref>'''Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis.''' Andrea Cipriani, MD. Published in the Lancet. February 21, 2018 DOI:<nowiki>https://doi.org/10.1016/S0140-6736(17)32802-7</nowiki></ref>, relative to other treatments psychedelics lack the majority of serious adverse effects.

**'''Obsessive compulsive disorder (OCD)'''

*'''Cyclical behavioural patterns:'''  

**'''Alcoholism''' - the founder of AA cured his alcoholism using LSD<ref>'''A Radical New Approach to Beating Addiction'''. Psychology Today. Retrieved February 24, 2019, also Francis Hartigan Bill Wilson p. 177-179.</ref>.

**'''Tobacco Use''' - small study has shown an 80% cessation rate after 6 months which compare to the industry standard of 35%<ref>'''An online survey of tobacco smoking cessation associated with naturalistic psychedelic use.''' Journal of Psychopharmacology, ''31(7), 841–850.'' Johnson, M. W., Garcia-Romeu, A., Johnson, P. S., & Griffiths, R. R. (2017).  doi:10.1177/0269881116684335. Accessed on 14th February 2023 via: https://pubmed.ncbi.nlm.nih.gov/28095732/</ref>.

**'''Hyper-Consumerism''' - several peer-reviewed studies have shown that psychedelics also work as ''[[ecodelics]]'', medicines which can induce ecological concern<ref>'''Catalysts for Transformation: A systematic literature review exploring the interlinkages and potential role of classic psychedelics to social-ecological sustainability.''' Marion Nilsson, Lund University Centre for Sustainability Studies. Accessed on 30 January 2023 via: https://lup.lub.lu.se/luur/download?fileOId=9031166&func=downloadFile&recordOId=9031164</ref><ref>'''Accidental Environmentalism: Nature and Cultivated Affect in European Neoshamanic Ayahuasca Consumption'''. Arne Harms University of Leipzig. Accessed on 30 Jan 2023 via https://www.proquest.com/openview/e872aeede38122f158ef3d84fbc39c38/1?cbl=18750</ref><ref>'''Acute, subacute and long-term subjective effects of psilocybin in healthy humans: a pooled analysis of experimental studies'''. Studerus E, Kometer M, Hasler F, Vollenweider FX.  J Psychopharmacol. 2011 Nov;25(11):1434-52. doi: 10.1177/0269881110382466. Epub 2010 Sep 20. PMID: 20855349. Accessed on 12 December 2022 via: https://pubmed.ncbi.nlm.nih.gov/20855349/</ref><ref>'''Connectedness to Nature and to Humanity: their association and personality correlates'''. Front. Psychol., 21 July 2015. Sec. Personality and Social Psychology. Kibeom Lee, Michael C. Ashton, Julie Choi and Kayla Zachariassen. https://doi.org/10.3389/fpsyg.2015.01003. Accessed on 3rd October 2022 via https://www.frontiersin.org/articles/10.3389/fpsyg.2015.01003/full</ref><ref>'''Increased nature relatedness and decreased authoritarian political views after psilocybin for treatment-resistant depression'''. Journal of Psychopharmacology. Taylor Lyons, Robin L Carhart-Harris. https://doi.org/10.1177/0269881117748902. Accessed on 3rd October 2022 via https://journals.sagepub.com/doi/full/10.1177/0269881117748902</ref><ref>'''Psychedelics, Personality and Political Perspectives'''. Matthew M Nour 1, Lisa Evans 2, Robin L Carhart-Harris DOI: 10.1080/02791072.2017.1312643. 2017 Jul-Aug;49(3):182-191. doi: 10.1080/02791072.2017.1312643. Epub 2017 Apr 26. Accessed on 3rd October 2022 via https://pubmed.ncbi.nlm.nih.gov/28443703/</ref><ref name=":1">'''''Manifesting Minds: A Review of Psychedelics in Science, Medicine, Sex, and Spirituality'''''. Doblin, Rick; Brad Burge (2014)  North Atlantic Books. <nowiki>ISBN 1583947272</nowiki>.</ref><ref name=":2">'''Lifetime experience with (classic) psychedelics predicts pro-environmental behavior through an increase in nature relatedness'''. Matthias Forstmann and Christina Sagioglou Journal of Psychopharmacology 2017.  DOI: 10.1177/0269881117714049. Accessed on 30th September 2022 via: https://pubmed.ncbi.nlm.nih.gov/28631526/</ref><ref name=":3">'''From Egoism to Ecoism: Psychedelics Increase Nature Relatedness in a State-Mediated and Context-Dependent Manner'''. Hannes Kettner, Sam Gandy, Eline C. H. M. Haijen and Robin L. Carhart-Harris Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London. International Journal of Environmental Research and Public Health. Published: December 2019 DOI: 10.3390/ijerph16245147. Accessed on 30th September 2022 via: https://pubmed.ncbi.nlm.nih.gov/31888300/

Psychedelics induce [[Neuroplasticity|neuroplastic]], [[Pivotal mental state|pivotal mental states]]. It is thought psychedelics mediate this effect by altering the Brain-Derived Neurotrophic Factor (BDNF)<ref>'''Psychedelics and Neuroplasticity: A Systematic Review Unraveling the Biological Underpinnings of Psychedelics''' Cato M. H. de Vos, Natasha L. Mason and Kim P. C. Kuypers* Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands Front. Psychiatry, 10 September 2021 </ref> receptor TrkB<ref>'''Psychedelics promote plasticity by directly binding to BDNF receptor TrkB'''. Rafael Moliner, Mykhailo Girych. Published: 05 June 2023 in Nature Neuroscience. Accessed on 8 Jun 2023 via: <nowiki>https://www.nature.com/articles/s41593-023-01316-5</nowiki></ref>.

The most commonly used psychedelics, [[Psilocybin]], DMT and LSD have a very similar effect<ref>'''Effects of Naturalistic Psychedelic Use on Depression, Anxiety, and Well-Being''': Associations With Patterns of Use, Reported Harms, and Transformative Mental States. Front. Psychiatry, 15 March 2022. Sec. Psychopharmacology. <nowiki>https://doi.org/10.3389/fpsyt.2022.831092</nowiki></ref><ref name=":0">'''Direct comparison of the acute effects of lysergic acid diethylamide and psilocybin in a double-blind placebo-controlled study in healthy subjects.''' Holze, F., Ley, L., Müller, F. ''et al.'' ''Neuropsychopharmacol.'' 47, 1180–1187 (2022). <nowiki>https://doi.org/10.1038/s41386-022-01297-2</nowiki></ref><ref>'''Double-blind comparison of the two hallucinogens psilocybin and dextromethorphan: similarities and differences in subjective experiences.''' Carbonaro TM, Johnson MW, Hurwitz E, Griffiths RR.  Psychopharmacology (Berl). 2018 Feb;235(2):521-534. doi: 10.1007/s00213-017-4769-4. Epub 2017 Nov 7. PMID: 29116367; PMCID: PMC6645364.</ref><ref>'''Comparison of the Reactions Induced by Psilocybin and LSD-25 in Man'''. From the National Institute of Mental Health, Addiction Research Center, U. S. Public Health Service, Lexington, Kentucky by HARRIS ISBELL 1959</ref> whilst dissociative psychedelics like [[ketamine]] have a more of an [[Out of Body Experiences|Out of Body Experience]] effect. This is backed up by recent, real world evidence analysis of 2947 publicly available, [https://www.erowid.org/ erowid.org] trip reports which concluded:  

|20-50 μg

|150 μg<ref>'''Dose-response relationships of LSD-induced subjective experiences in humans'''. Journal of neuropsychopharmacology Tim Hirschfeld, Johanna Prugger, Tomislav Majić & Timo T. Schmidt. Published: 09 May 2023, accessed on 4 Jun 2023 via <nowiki>https://www.nature.com/articles/s41386-023-01588-2</nowiki></ref>

|[[DMT]]

|5-10 mg

|40 mg

|[[Psilocybin|Psilocin]]

|35 mg

|75-140mg

A key effect of psychedelics is their ability to open a period of neuroplasticity where old habits can be erased and new habits formed. This period has been found to differ substantially between the various compounds (see '''Figure 5''').

There are a category of patients that have specific conditions or are taking specific medicines that should be [[Psychedelic Therapy Exclusion Categories|excluded from psychedelic therapy]]:

* People taking '''SSRIs''': citalopram (Cipramil), dapoxetine (Priligy)<nowiki/>, escitalopram (Cipralex), fluoxetine (Prozac or Oxactin)  may experience [[SSRI and psychedelics|serotonin syndrome]], this is more pronounced in those taking [[MDMA]];

* People taking '''olanzapine''' (an atypical antipsychotic) as there is some evidence to suggest it can [[Trip Terminator|''terminate'' a trip]]<ref>'''Olanzapine as the ideal “trip terminator”?''' Giuseppe Valeriani, Ornella Corazza, Francesco Saverio Bersani. First published: 28 July 2015 <nowiki>https://doi.org/10.1002/hup.2431</nowiki>. Accessed via: <nowiki>https://onlinelibrary.wiley.com/doi/10.1002/hup.2431</nowiki></ref>;

* Presence or history of mania or '''bipolar disorder''';

Like all medicines, without proper guidance, adverse effects can occur, many of which can be reduced by utilising proper [[Psychedelic Therapy Inclusion and Exclusion Criteria|inclusion and exclusion criteria]]. As shown in '''Figure 3''', relative to other popular medicines psychedelics cause much less harm. However, there have been some [[Adverse Psychedelic Effects|adverse psychedelic effects]] which have been linked to the intensity and duration of the experience<ref>'''Extended difficulties following the use of psychedelic drugs''': A mixed methods study Evans, J., Queen Mary University. Accessed on 31 July 2023 via: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4505228</ref>.